Sentinel lymph node mapping and biopsy for ductal carcinoma in situ and other controversial indications.

This review discusses the currently available literature regarding three controversial indications for sentinel node mapping for breast cancer patients. For women with ductal carcinoma in situ (DCIS), the use of sentinel lymph node mapping (SLNM) should be limited to women having a mastectomy. For patients with multifocal breast carcinoma, SLNM is accurate when a retroareolar injection technique is employed in the procedure. When treatment plans for node-negative patients call for neoadjuvant chemotherapy, accurate sentinel node mapping can be performed prior to the administration of chemotherapy. The resolution of these and other controversies should result in the expansion of the number of patients evaluated with SLNM in the future.